Tromboseprofylaxe in de orthopedische chirurgie: de klinische praktijk in Nederland anno 2002

Establish the use of thromboprophylaxis in orthopaedic surgery both during and after the hospital admission.

Design

Cross-sectional study.

Method

In April 2002, a letter was sent to all orthopaedic surgeons in the Netherlands announcing that at every hospital with a Department of Orthopaedic Surgery, an orthopaedic surgeon would be approached for a telephone survey. They were phoned in the months April-June 2002. This study included hospitals where major orthopaedic surgery (e.g. the insertion of hip or knee prostheses and hip fracture surgery) took place (n = 124) as well as clinics that only performed day treatments (n = 5).

Results

For major orthopaedic operations, 91 of the hospitals used low molecular weight heparin (LMWH) during the admission period: 36 as monotherapy and 55 in combination with coumarin derivates. In 85 of cases the use of LMWH was started preoperatively. Coumarin derivates were used as a monotherapy in 9 of the hospitals. In 37 of the hospitals the use of NSAIDs was continued, particularly in patients with rheumatoid arthritis. In 94 of the hospitals, the use of acetylsalicylic acid was always stopped. In 97 of the hospitals prophylaxis was given after discharge in the form of LMWH (37 of the cases) or coumarin derivates (63 of the cases). The use of thromboprophlaxis with respect to arthroscopies and plaster immobilisation was variable.